Blood Pressure Control and Hormone Replacement Therapy in Postmenopausal Women at Risk for Coronary Heart DiseaseAmerican Heart Journal
AbstractCoronary Heart Disease (CHD) in women is strongly associated with estrogen deprivation. For example, risk for CHD increases dramatically after menopause, however the role of hormone replacement therapy in CHD prevention is currently unresolved. In order to better understand CHD in women, the precise mechanisms by which estrogen affects circulatory function require clarification. Evidence suggests that exogenous estrogen may affect blood pressure control, but its interaction with other CHD risk factors has not been systematically characterized. The present study examines the role of mildly elevated resting blood pressure, family history of CHD and hormone replacement on blood pressure responses to stress in postmenopausal women. Methods and Results Postmenopausal women taking chronic hormone replacement therapy were recruited along with a control group of postmenopausal women not taking hormone replacement. These women were divided into higher versus lower risk for CHD based on level of resting blood pressure and family history of CHD. Blood pressure control mechanisms were assessed by measurement before, during and after a computer-controlled laboratory stressor. Results indicate that women with elevated resting blood pressure and positive family history of CHD have exaggerated blood pressure reactivity to stress, and hormone replacement therapy inhibits this effect of risk on blood pressure reactivity.
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